| Full Name of Deceased |
Nelson
Payne |
| Color |
White |
| Sex |
Male |
| Age |
22 |
| Name of Father of Deceased |
John Payne |
| Name of Mother of Deceased |
Sarah Payne |
| Occupation |
Farmer |
| Place of Birth |
England |
| Name of Wife of Deceased |
|
| Name of Husband of Deceased |
|
| Date of Birth |
Oct. 22, 1854 |
| Date of Death |
June 23, 1877 |
| Cause of Death |
Scarlet Fever |
| Name of place, town or township,
and county in which person died |
Peshtigo, Wis. |
| Name and location of burial
ground in which interned |
Peshtigo, Wis. |
| Name of person returning certificate |
L. J. Smith |
| Residence of such person |
Peshtigo |
| Date of Certificate |
July 28, 1877 |
| Date of Registration |
Oct. 13, 1877 |
| Other Information |
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